Objective　The covered tracheal stent in shape of a straight tube or a fork-like tube was placed clinically to treat tracheal stricture and tracheal fistula caused by malignant tumour in order to maintain the normal function respiration and to keep the fistula closed.Methods　The stent was made of stainless steel in shape of "Z"covered with membrane partially or entirely.An instrument with tube in three sheathes was used to place the stent in position.Results　The tracheal stents were placed successfully in 9 cases at first time and the esophageal stents were placed for 6 cases among them in the meantime.Dyspnea of patiants was remarkably alleviated.The tracheal fistula of them was closed effectivelly.Follow-up for 4～12 monthes all cases demonstrated no adverse effects.Conclusion　The application of the covered stent is a safe effective method to treat the tracheal stricture and tracheal fistula.

OBJECTIVE Investigating the distribution and drug-resistance of pathogenic bacteria in urinary tract infecion for children in Wuhan region to provide the evidence of diagnoses and treatment for clinician.METHODS The positive results of urine culture of 405 children with urinary tract infections from Jul 2002 to Dec 2005 were analyzed.All of the isolates were tested by Kirby-Bauer susceptibility method.RESULTS Among 405 pathogens,the majority was Escherichia coli which occupied 36.7%;then Enterococcus accounted for 29.4%.Totally 405 pathogens all showed the higher drug resistance,while antibacterial antivities of imipenem,amikacin and furantoin to E.coli and Klebsiella pneumoniae and of glycopeptides,high concentration of streptomycin and furantoin to Enterococcus were preserved well.CONCLUSIONS The effective measurements and reasonable use of antibiotics should be taken to hold back the occurrence and prevalence of urinary tract infecion for children.

OBJECTIVE To study the distribution of drug-resistant gene of meticillin-resistant coagulase negative Staphylococcus(MRCNS) in children septicemia.METHODS The total MRCNS isolates were 40,and whether in there harbored genes mec,erm and qac was studied.RESULTS Among 40 CNS strains,in there harbored genes mec,erm,and qac were 38(95.0%),30(75.0%) and 18(45.0%),respectively.CONCLUSIONS MRCNS in children septicemia where harbor drug resistance genes is very serious,so we should pay great heed to its effective control.

OBJECTIVE To investigate dynamically antibiotic resistance changing of Escherichia coli in Hubei province and provide the reference for clinical rational application of antibiotics.METHODS The WHONET4-5 software was used to analyze the antibiotic resistant rates of 2901 strains of E.coli isolated from all kinds of clinical specimen of children from 2003 to 2006 in the third grade hospitals of Hubei province.RESULTS Drug-resistance rate of E.coli in children group was lower than that in adult group.Except for 100.0% susceptibility to carbopenems such as imipenem and Meropenem,in the four years,drug-resistance of the other antibiotics showed ascending tendency.Ampicillin showed the highest drug-resistance rate(84%-90%).The lower(3%-25%) were amikacin,cefoxitin,ceftazidime,cefepime.CONCLUSIONS Antibiotic resistance of E.coli in children in Hubei province showed the ascending tendency.We should take effective measurement to control the spread and prevalence of the drug-resistant bacteria.

OBJECTIVE To approach biosafety risks in laboratory department of children′s hospital to formulate the managemen strategy.METHODS The existing biosafety risk in laboratory department of children′s hospital was investigated and analyzed.RESULTS A series of problems such as personnel′s biosafety consciousness,work environment,protection equipment,a medical orderly′s training,etc were existing.CONCLUSIONS Biosafety regulations should be executed strictly in children′s hospital,and biosafety management should be highly paid attention to and consummated.

Objective To study the effects of the inhibition of nuclear factor kappa-B ( NF-κB) , on the hepatic heat shock protein 70 (HSP70) expression as well as on the changes of hepatic function and ultrastructure in a rodent model of hemonhageic shock. Method Hemorrhagic shock was produced by inducing bilateral femoral fractures in male Wistar rats. Intraperitoneal injection of pyrrolidine dithiocarbamate(PDTC)was used to inhibit NF-κB activation 1 hour before induction of shock. A total of 66 adult male Wistar rats were randomly divided into 3 groups: control group (Control, n = 6), trauma shock (TS, n = 30), and NF-κB inhibition followed by trauma shock (NF-κB inhibition, n =30). Measurements of hepatic NF-KB and HSP70, hepatic function bio-markers, TNF-α and IL-6 were obtained 0.5, 2, 4, 6, 8 hours after trauma. Histopathological changes in liver tissues were also noted. Hepatic expression of NF-κB was determined by using electrophoretic mobility shift assay, while HSP70 was assayed by western blot and analyzed with computer imaging. Results In rats with trauma shock, both hepatic NF-κB activity and HSP70 expression increased significantly compared to the control group, reaching peaks at 6 hour post injury. Serum alanine transferase (ALT) and total bilirubin (TB) also rose significantly,reaching peaks at 8 hours post trauma. Light microscopy revealed hepatic congestion with infiltration of inflammatory cells into hepatic sinusoid in the TS group at 8 hours. Inhibiting the activity of NF-κB one hour before trauma significantly decreased expression of HSP70 at 6 hours post trauma [16.9±4.4 (NF-κB inhibition) vs. 23.0±1.7 (TS), P ＜ 0.05]. In addition,levels TNF-α and IL-6 in the liver tissue also decreased, and hepatic congestion as well as hepatic cell degeneration were ameliorated, showing minimal inflammatory infiltrates in the hepatic sinusoids. NF-κB inhibition also significantly lowered the levels of ALT and TB at 4 hours post trauma [ALT, 540.8 ±66.2 nmol/L (NF-KB inhibition) vs. 640.6±80.2 nmol/L (TS), P ＜ 0.05; TB,2.3±0.3 mol/L (NF-κB inhibition) vs. 4.7 ±1.1 mol/L (TS), P ＜ 0.05]. Conclusions NF-κB and HSP70 are involved in the pathogenesis of hepatic injury during hemorrhagic shock, and the degree of NF-κB activity and HSP70 expression may be consistent with the extent of hepatocellular damage. Inhibition of NF-κB helps ameliorate liver injury due to trauma shock.

AIM: To investigate the functions of GR in the course of hepatic secondary injury after severe multiple injury. METHODS: Rat model was produced by adopting severe thoracic impact injury accompanied with mono-side femur fracture, and glucocorticoid receptor was blocked before severe multiple injury. Hepatic macropathology and alterations under light microscope were examined. Maximal binding volume of glucocorticoid receptor (GR) in hepatic tissue was assayed by radio-ligand binding assay and protein content was assayed by Western blot. RESULTS: Maximal binding volume and protein content of GR were gradually decreased in hepatic tissue after severe multiple injury, obviously lower than that in normal control at 4 h after trauma ( P

Objective:To evaluate the curative effect of Fumai Zhuyu Decoction on deep vein thrombosis (DVT) after orthopedic surgery.Methods:According to random method, 90 patients with DVT after orthopedic surgery who met inclusion criteria in the hospital were divided into two groups between January 2018 and December 2020, 45 cases in each group. Both groups were given DVT catheterization for thrombolysis. After that, control group was given subcutaneous injection of low molecular weight heparin calcium, while observation group was additionally treated with Fumai Zhuyu Decoction. All were continuously treated for 14d. Before and after treatment, scores of TCM syndromes were evaluated. The coagulation response time (R), clotting time (K), clotting angle (α) and maximum strength of blood clotting (MA) were detected by full-automatic thromboelastometry analyzer. The levels of serum IL-6 and CRP were detected by ELISA. The hematocrit (Hct) was calculated according to red cell casts and whole blood height. The adverse reactions were recorded. And the clinical curative effect was evaluated.Results:The differences in total response rate between observation group and control group were statistically significant [82.2% (37/45) vs. 62.2% (38/45); χ2=4.49, P=0.034]. After treatment, scores of affected limb pain, dark encrusted skin and affected limb swelling in observation group were significantly lower than those in control group ( t values were 7.26, 7.14, 6.88, respectively, all Ps<0.001). After treatment, R [(6.12±0.86) min vs. (5.45±0.56) min, t=3.58] and K [(2.24±0.45) min vs. (1.72±0.42) min, t=4.63] in observation group were significantly longer than those in control group ( P<0.01), α [(51.69±2.23)° vs. (54.23±2.42)°, t=4.23] and MA [(51.58±3.62) min vs. (54.58±3.53) min, t=3.25] were significantly lower than those in control group ( P<0.01), and levels of serum IL-6, CRP and Hct were significantly lower than those in control group ( t values were 2.66, 2.96, 7.58, respectively, all Ps<0.01). During treatment, differences in incidence of adverse reactions between observation group and control group were statistically significant [6.7% (3/45) vs. 22.2% (10/45); χ2=4.41, P=0.036]. Conclusion:The Fumai Zhuyu Decoction can reduce blood viscosity, prevent thrombosis and improve clinical curative effect in patients with DVT after orthopedic surgery.

OBJECTIVETo investigate the plasma levels of coagulation factor VII (FVII) and polymorphisms of FVII gene in patients with coronary heart disease (CHD), and evaluate the effect of plasma FVII levels and FVII gene polymorphisms on CHD.

METHODSPlasma FVIIa, FVII: Ag and FVIIc were measured and polymorphisms of FVII gene were analyzed in 149 control cases and 60 CHD cases, including 33 acute myocardial infarction (AMI) cases by a combination of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and agarose gel electrophoresis.

RESULTSFVIIa, FVIIc in AMI group were significantly higher than that in control group, but FVII: Ag wasn't. There were no significant difference in plasma FVIIa, FVII: Ag and FVIIc between CHD and control group. The IVS7 genotypic frequency in AMI group was significantly different from that in control group. There was no significant difference in genotypic frequencies and allelic frequencies in other polymphism sites. FVII: Ag was significantly higher in -402A homozygote than that in -402G homozygote.

CONCLUSIONSIncreased FVII levels, especially FVIIa and FVIIc in plasma, may contribute to coronary artery thrombosis. There was significant difference in IVS7 genotype frequency between control and AMI groups, but the rest weren't significantly different. FVII: Ag was significantly higher in -402A homozygote than that in -402G homozygote. Polymorphism of -402 G/A may play an indirect role in AMI by regulating plasma FVII levels.

Coronary Disease ; blood ; genetics ; Factor VII ; analysis ; genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.